Blood culture in ED prior to initial antibiotic

What It MeansThe percentage of patients with pneumonia who have a blood culture performed in the Emergency Department prior to receiving antibiotics in the hospital.

Why It Is ImportantWe know that when a patient with pneumonia has a blood culture (a test showing what disease organisms are present in the patient's blood) before receiving antibiotics, the physician has a much better idea how sick the patient really is and which antibiotic will be most helpful. If the antibiotics are given before the blood culture, the information the physician has to work with is not as clear and accurate.

Numerator DefinitionNumber of inpatients whose initial emergency room blood culture was performed prior to the administration of the first hospital dose of antibiotics.

Denominator DefinitionPneumonia patients 18 years of age and older who have an initial blood culture collected in the emergency department.

Denominator Excluded Populations

Patients who had no diagnosis of pneumonia either as the ED final diagnosis/impression or direct admission diagnosis/impression

Patients receiving Comfort Measures Only on day of or day after arrival

Patients less than 18 years of age

Patients who do not receive antibiotics or a blood culture

Patients who had no chest x-ray or CT scan that indicated abnormal findings within 24 hours prior to hospital arrival or anytime during this hospitalization

Patients with Cystic Fibrosis (Appendix A, Table 3.4)

Patients transferred to another acute care hospital or federal hospital on day of or day after arrival

Patients who expired on day of or day after arrival

Patients who left against medical advice on day of or day after arrival

Patients involved in clinical trials

Patients who only received antibiotics prior to hospital arrival

Patients who have a blood culture collected within 24 hours prior to hospital arrival

Patients who have a final diagnosis/impression of pneumonia upon direct admit